Shaking Up Systems To Achieve Health Equity

Mar 17, 2016, 10:00 AM, Posted by

In order to achieve greater health equity in America, we need to co-create solutions aimed at transforming the many systems that influence where we live, learn, work and play.

A small girl in a supermarket, holding a bunch of bananas.

Babies born in the shadow of Yankee Stadium are likely to be lifelong fans of the Bronx Bombers. They are also likely to live seven years less than a baby born a handful of subway stops south near Lincoln Center. The same is true in Las Vegas, where a baby born near The Strip is likely to live nine or 10 years less than someone born west of town.

When it comes to health across cities, zip codes are unequal and so are health outcomes. For example, ethnic minorities continue to experience higher rates of morbidity and mortality than whites. Among the 10 leading causes of mortality in the U.S. (e.g., heart disease, cancer or stroke), minority populations experience the highest rate of death.

We write often about the disparities between population groups and the day-to-day experiences of individuals who, for a myriad of reasons—systemic, geographic or financial—do not have the same opportunity to live as healthy a life as their fellow citizens. Our goal is greater health equity in America, a process that begins with including those most affected and co-creating solutions to improve the systems that negatively impact health. The end result should be decreased health disparities.

Here at the Foundation, we know that health disparities are more often caused by systems related to non-medical determinants of health, which is why we’ve specifically invested more than $457 million since 2014 toward eliminating these pervasive gaps in health outcomes.

Overview of the RWJF Awards for Health Equity

We know that in order to address disparities head on, we'll have to implement changes to systems that influence where we live, learn, work and play. To improve systems, we must re-examine and refresh the policies and practices of corporations, government agencies, nonprofits and other organizations, both within and across sectors that influence the determinants of health in our lives. Improving how these systems work—both independently and together—gets us closer to achieving health equity.

That’s why last year we introduced the RWJF Awards for Health Equity: to seek out national nonprofit organizations that could help find the champions of system change within or across sectors. Our awardees have included Youth Move National, the National Association of Free & Charitable Clinics, and the Community-Campus Partnerships for Health, National Recreation and Park Association, Asian & Pacific Islander Caucus for Public Health, and the National Civic League.

This year, we want to broaden our perspective, so we’re looking for organizations specifically representing the business, media, faith-based and philanthropic sectors. These organizations must have experience with systems changes that influence access to quality health care, education, employment, income, community, environment, housing or public safety.

A total of four grants of up to $52,000 each will be awarded, with each grant supporting an annual awards program for six years. Each year, the four selected organizations will independently evaluate nominations of individuals from within their sectors, and select a winner for the award based upon their selection process. The award recipients each organization selects will receive an unrestricted cash prize from the organization and national recognition, in addition to attending an annual RWJF-hosted event to honor and learn from the award recipients and grantee organizations.

Examples of How Media, Faith and Business are Challenging Systems


The Solutions Journalism Network exemplifies an organization that’s driving systems change in the media—one of the four sectors we’re targeting. By definition, solutions journalism is rigorous and compelling reporting on responses to social problems, not an easy task in a world of 24-hour breaking news. The Network increases the volume and quality of reporting by developing a community of journalists focused like no other group of journalists on the need for systems change. It addresses areas as diverse as legal aid, the treatment of disabled adults, and blight reduction.


When it comes to understanding the disadvantages of a community, there is often no better resource than the faith-based organizations addressing disparity at the neighborhood level. They’re adept at collaborating across sectors and stakeholders. They often serve communities most desperate for assistance, with the best understanding of their needs. Through a series of listening sessions in the Southern & Appalachian States—a region that suffers from some of the poorest health and shortest life expectancy rates in the United States—we learned about how faith organizations are working with other sectors to promote health.


For decades, health and private industry were linked in people’s minds only by employee wellness programs or employee-sponsored health insurance. But in a Culture of Health, business can be a powerful ally with a common goal. Every year, U.S. businesses lose more than $225 billion due to sick and absent workers, while spending almost $400 billion a year to insure them. Colleagues like the U.S. Federal Reserve System, the Health Enhancement Research Organization, and The Reinvestment Fund are supporting efforts to improve health, reduce health care costs, and support the community through socially responsible investment.

By finding success stories from sectors like these and celebrating their champions, we are pushing beyond the envelope of public health to raise visibility and awareness for the types of real efforts this nation needs to achieve greater health equity.

Eliminating health disparities is a bold and ambitious goal, but we believe it is both achievable and necessary to ensure the health and prosperity of our nation. While we embed the lens of equity in all that we do, the Awards will serve as a clear indicator to potential partners outside public health that all people—no matter their background, heritage, socioeconomic status or current state of well-being—have an equal right to live longer, healthier lives.

Headshot of Dwayne Proctor, PhD

Dwayne Proctor, PhD, is senior adviser to the President and director who believes that the Foundation’s vision for building a Culture of Health presents a unique opportunity to achieve health equity by advancing and promoting innovative systems changes related to the social determinants of health. 



Headshot of Catherine Malone

Catherine Malone, MBA, is a program officer who works in the areas of diversity and nursing. Malone has worked on programs aimed at improving nursing retention, transforming the organizational culture of hospitals and engaging partners to address nursing issues. Read her full bio